<strong>Objective</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong...<strong>Objective</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> To summarize the nursing experience of induced labor of upper gastrointestinal bleeding in pregnancy complicated with decompensated cirrhosis. </span><b><span style="font-family:Verdana;">Methods</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> To treat two pregnant women with upper gastrointestinal bleeding complicated with decompensated cirrhosis with early labor induction, strengthen the nursing of upper gastrointestinal bleeding before </span><span style="font-family:Verdana;">operation</span><span style="font-family:Verdana;">, monitor changes of the patient</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">’</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">s condition closely after </span><span style="font-family:Verdana;">operation</span><span style="font-family:Verdana;">, and strengthen</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">the prevention and treatment of postpartum complications and health guidance. </span><b><span style="font-family:Verdana;">Results</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> No serious complications occurred in the 2 patients after </span><span style="font-family:Verdana;">operation</span><span style="font-family:Verdana;">. They were hospitalized for 11 and 17 days after </span><span style="font-family:Verdana;">operation</span><span style="font-family:Verdana;"> and were discharged stably. </span><b><span style="font-family:Verdana;">Conclusion</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> The pregnant women with upper gastrointestinal bleeding complicated with decompensated cirrhosis should terminate pregnancy in time and strengthen perinatal nursing, which can improve the liver function and blood coagulation and improve the prognosis of the patients.</span></span></span>展开更多
Hepatic artery aneurysm (HAA) is a rare disease. HAA is generally asymptomatic disease when symptomatic, they usually present with abdominal pain, upper gastrointestinal (GI) bleeding and/or jaundice, hypovolaemia sec...Hepatic artery aneurysm (HAA) is a rare disease. HAA is generally asymptomatic disease when symptomatic, they usually present with abdominal pain, upper gastrointestinal (GI) bleeding and/or jaundice, hypovolaemia secondary to rupture or GI bleeding with normal GI endoscopy. Surgical repair and endovascular treatment are the two therapeutic options available at present. Case report: A 49-year-old male presented at the emergency department with high gastrointestinal bleeding, abdominal pain and jaundice. Gastroscopy showed an ulcer with flat pigmented haematin on ulcer base (Forrest IIc) that was controlled by medical treatment. CT angiography was done and showed aneurysm of the proper hepatic artery almost totally thrombosed measuring 100 × 59 mm associated with signs of contained rupture. Emergency surgery was indicated. The laparotomy objectified a rupture of the aneurysm in the biliary tree in per operative excision of aneurysm and ligation of the hepatic pedicle was carried out. After surgery, the evolution was favorable with a follow-up of 8 months. Conclusion: HAA rupture is a rare cause of upper GI bleeding. The mortality rate after rupture is relatively high. CT angiography or MRI can diagnose a ruptured of HAA. Urgent surgery should be the first choice in patients with a ruptured HAA with active hemorrhage causing hemorrhagic shock.展开更多
AIM To study and describe patients who underwent treatment for gastric antral vascular ectasia(GAVE) with different endoscopic treatment modalities.METHODS We reviewed patients with GAVE who underwent treatment at Uni...AIM To study and describe patients who underwent treatment for gastric antral vascular ectasia(GAVE) with different endoscopic treatment modalities.METHODS We reviewed patients with GAVE who underwent treatment at University of Alabama at Birmingham between March 1, 2012 and December 31, 2016. Included patients had an endoscopic diagnosis of GAVE with associated upper gastrointestinal bleeding or iron deficiency anemia.RESULTS Seven out of 15 patients had classic watermelon description for GAVE, 1/15 with diffuse/honeycomb pattern and 6/15 with nodular GAVE per EGD description. Seven out of 15 patients required multimodal treatment. Four out of six of patients with endoscopically nodular GAVE required multimodal therapy. Overall, mean pre-and post-treatment hemoglobin(Hb) values were 8.2 ± 0.8 g/dL and 9.7 ± 1.6 g/dL, respectively(P ≤ 0.05). Mean number of packed red blood cells transfusions before and after treatment was 3.8 ± 4.3 and 1.2 ± 1.7(P ≤ 0.05), respectively.CONCLUSION Patients with nodular variant GAVE required multimodal approach more frequently than non-nodular variants. Patients responded well to multimodal therapy and saw decrease in transfusion rates and increase in Hb concentrations. Our findings suggest a multimodal approach may be beneficial in nodular variant GAVE.展开更多
文摘<strong>Objective</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> To summarize the nursing experience of induced labor of upper gastrointestinal bleeding in pregnancy complicated with decompensated cirrhosis. </span><b><span style="font-family:Verdana;">Methods</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> To treat two pregnant women with upper gastrointestinal bleeding complicated with decompensated cirrhosis with early labor induction, strengthen the nursing of upper gastrointestinal bleeding before </span><span style="font-family:Verdana;">operation</span><span style="font-family:Verdana;">, monitor changes of the patient</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">’</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">s condition closely after </span><span style="font-family:Verdana;">operation</span><span style="font-family:Verdana;">, and strengthen</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">the prevention and treatment of postpartum complications and health guidance. </span><b><span style="font-family:Verdana;">Results</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> No serious complications occurred in the 2 patients after </span><span style="font-family:Verdana;">operation</span><span style="font-family:Verdana;">. They were hospitalized for 11 and 17 days after </span><span style="font-family:Verdana;">operation</span><span style="font-family:Verdana;"> and were discharged stably. </span><b><span style="font-family:Verdana;">Conclusion</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> The pregnant women with upper gastrointestinal bleeding complicated with decompensated cirrhosis should terminate pregnancy in time and strengthen perinatal nursing, which can improve the liver function and blood coagulation and improve the prognosis of the patients.</span></span></span>
文摘Hepatic artery aneurysm (HAA) is a rare disease. HAA is generally asymptomatic disease when symptomatic, they usually present with abdominal pain, upper gastrointestinal (GI) bleeding and/or jaundice, hypovolaemia secondary to rupture or GI bleeding with normal GI endoscopy. Surgical repair and endovascular treatment are the two therapeutic options available at present. Case report: A 49-year-old male presented at the emergency department with high gastrointestinal bleeding, abdominal pain and jaundice. Gastroscopy showed an ulcer with flat pigmented haematin on ulcer base (Forrest IIc) that was controlled by medical treatment. CT angiography was done and showed aneurysm of the proper hepatic artery almost totally thrombosed measuring 100 × 59 mm associated with signs of contained rupture. Emergency surgery was indicated. The laparotomy objectified a rupture of the aneurysm in the biliary tree in per operative excision of aneurysm and ligation of the hepatic pedicle was carried out. After surgery, the evolution was favorable with a follow-up of 8 months. Conclusion: HAA rupture is a rare cause of upper GI bleeding. The mortality rate after rupture is relatively high. CT angiography or MRI can diagnose a ruptured of HAA. Urgent surgery should be the first choice in patients with a ruptured HAA with active hemorrhage causing hemorrhagic shock.
文摘AIM To study and describe patients who underwent treatment for gastric antral vascular ectasia(GAVE) with different endoscopic treatment modalities.METHODS We reviewed patients with GAVE who underwent treatment at University of Alabama at Birmingham between March 1, 2012 and December 31, 2016. Included patients had an endoscopic diagnosis of GAVE with associated upper gastrointestinal bleeding or iron deficiency anemia.RESULTS Seven out of 15 patients had classic watermelon description for GAVE, 1/15 with diffuse/honeycomb pattern and 6/15 with nodular GAVE per EGD description. Seven out of 15 patients required multimodal treatment. Four out of six of patients with endoscopically nodular GAVE required multimodal therapy. Overall, mean pre-and post-treatment hemoglobin(Hb) values were 8.2 ± 0.8 g/dL and 9.7 ± 1.6 g/dL, respectively(P ≤ 0.05). Mean number of packed red blood cells transfusions before and after treatment was 3.8 ± 4.3 and 1.2 ± 1.7(P ≤ 0.05), respectively.CONCLUSION Patients with nodular variant GAVE required multimodal approach more frequently than non-nodular variants. Patients responded well to multimodal therapy and saw decrease in transfusion rates and increase in Hb concentrations. Our findings suggest a multimodal approach may be beneficial in nodular variant GAVE.
